Document Detail


Treatment of patent ductus arteriosus with bidirectional flow in neonates.
MedLine Citation:
PMID:  21402454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patent ductus arteriosus is a common occurrence among prematurely born neonates and is believed to play a role in the development of other complications of prematurity including intraventricular hemorrhage, bronchopulmonary dysplasia, and necrotizing enterocolitis. The clinical decision to treat the patent ductus arteriosus is complicated by the lack of evidence available regarding clinical conditions under which closure should be attempted.
STUDY AIMS: To compare clinical outcomes for neonates who underwent treatment of patent ductus arteriosus exhibiting bidirectional blood flow versus those with flow that was left to right.
STUDY DESIGN: Cohort study of all neonates with patent ductus arteriosus in which medical closure was attempted at the Duke University between January 2002 and October 2007.
OUTCOME MEASURES: Death and other important clinical conditions.
RESULTS: We identified 20 neonates with bidirectional flow out of 317 cases in which medical closure of patent ductus arteriosus was attempted. There was no significant increase in overall complications due to closure of a bidirectional patent ductus arteriosus [40% (8/20)] versus ones with left to right shunting [38% (111/297) p=0.82]. Death occurred in 15% (3/20) with bidirectional PDA compared to 11% (34/297) in the left to right group, p=0.72.
CONCLUSION: The trend in mortality is worrisome but does not contraindicate an aggressive approach to the clinically significant PDA that has bidirectional flow at the time of the echocardiogram.
Authors:
Patrick N Ethington; P Brian Smith; Lakshmi Katakam; Ronald N Goldberg; C Michael Cotten
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-03-12
Journal Detail:
Title:  Early human development     Volume:  87     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-18     Completed Date:  2011-08-11     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  381-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Pediatrics, Duke University, Durham, NC 27710, United States.
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
Cohort Studies
Ductus Arteriosus, Patent / drug therapy*,  physiopathology*,  ultrasonography
Echocardiography
Female
Humans
Ibuprofen / administration & dosage*
Indomethacin / administration & dosage*
Infant, Newborn
Infant, Premature*
Male
Survival Analysis
Grant Support
ID/Acronym/Agency:
1K23HD060040-01/HD/NICHD NIH HHS; K23 HD060040-01/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 15687-27-1/Ibuprofen; 53-86-1/Indomethacin
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